Lynnette Michelle Khandaker, APRN-NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

60046 Issued in ID

Practice address

10112 W Overland Rd
Boise, ID 83709-1428

Phone

(087) 803-9002

Fax

(208) 375-2882

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.95 of 100Reported as group

Quality

67.72

Promoting interoperability

98

Improvement activities

40

Cost

63.78

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lynnette.khandaker.1@24259.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Renewed Hope Counseling and Wellness LLC

  dba Renewed Hope Counseling

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, ID
  • NPI 1861893661

  Single Specialty

  NPD (past)
• 4C Medical Group PLC

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1558654384

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1396292421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10112 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-780-3900",
            "fax_number": "208-375-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10112 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "087-803-9002",
            "fax_number": "208-375-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDAKER",
        "first_name": "LYNNETTE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AZ",
            "license": "RN201537",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP60046",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "60046",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ID",
            "license": "60046",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "60046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477920270",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Keys, LCPC, CS
• Tony D Keys, M.D.
• Keystone Center for Geriatrics LLC
• Abdul Khan
• Sidrah S Khan, LCSW
• Reema Arun Khanolkar
• Mona Fouad Khashan
• Kenneth George Khatain, M.D.
• Natalia Khochay, NP
• Tatiana V Khochay

• Primary Care Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.